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Continuing Education in Anaesthesia, Critical Care & Pain 2005 5(1):18-21; doi:10.1093/bjaceaccp/mki003
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 1 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia 2005

Treatment of chronic pain: antidepressant, antiepileptic and antiarrhythmic drugs

Sally-Ann Ryder, MRCP FRCA, Consultant in Anaesthesia and Pain Management
Royal Berkshire Hospital, Reading

Catherine F Stannard, FRCA, Consultant in Pain Medicine
Pain Clinic, Macmillan Centre, Frenchay Hospital, Bristol, BS16 1LE
Tel: 0117 975 3888, Fax: 0117 975 3825 E-mail: CFStannard{at}aol.com (for correspondence)

Chronic pain is complex physiologically and there are many influences on the pain experience. The approach to treatment therefore needs to be multimodal, often with a number of different interventions, both physical and psychological, delivered in parallel. Pharmacotherapy plays an important role in the management of persisting pain and the prescription of appropriate drugs is one of the key roles of the pain physician. Standard analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen alone, and in combination with minor opioids such as codeine, have often been prescribed before the patient is referred to the pain clinic. The use of strong opioids is becoming increasingly common.


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